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How to "Break Up" With a Bad Doctor

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July 8, 2010

July 8, 2010
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Hello, my loves! I want to thank you all for the wonderful well-wishes on my last and final surgery! I have come through with flying colors and am now getting the rest and recuperation that I need. I am so grateful for your love! Now let us get back to our snarkopolizing!

Last week we had such wonderful discussions on patients’ and doctors’ responsibilities for building good relationships. And I realized we never really discussed THE BIG BREAK UPS. You were so fabulous in the comments and discussions, and I wanted to give you big props on your views. Truly – I wanted to wax poetic about my favorite walkout methods too. BE BOLD, PEOPLE. If you’re going to walk out on your doctor – JUST DO IT NIKE STYLE.

METHOD 1: THE WALKOUT

Really, though - I like to think you are all so super smart that you needn’t have a “big break up.” Hopefully you are better at my preferred method – THE WALKOUT.

This is my favorite method of culling s****y doctors. Once you MUST go to a new specialist – then it is on both you and the doctor to have a good interaction. However, if it is not going well from the beginning, I’m a huge fan of a no-nonsense method - THE WALKOUT.

I will compare and contrast to you the difference by showing you the perfect scenario:

My first visit to see my neurologist, I was sick with seizures, brain swelling, and THE WHOLE SPIEL. He didn’t blink. He literally grabbed my hand and said to me, “Melissa, I love complicated cases. I am a high risk doctor and we WILL GET TO THE BOTTOM OF THIS. I will stay with you the entire time.” And he did. Now – to be fair – I lost faith many times – but HE NEVER DID. Meanwhile – he ordered dozens of tests and sent me to DOZENS of doctors. Many of them were not the right one for me, because I did not have an infectious disease, nor was I dying of dread pirates disease – though I’m hoping it does show up on my grave stone and death certificate.

During this time, all my test results had come back with positive ANA and stupidly high SED rates and EEGs with seizures, etc. And you cannot fake those. He’d put me in the hospital and tested for meningitis at one point, and even written in his notes, “I think this patient has lupus or another autoimmune disorder - she needs a rheumatologist.”

So, I went to one after the other, but they were not lupus specialists. On this particular day I had an appointment to see a rheumatologist who was supposed to be the queen of lupus. But he was sick that day, so I got to see a standin who should be retired. He’s a d***. This man grabbed my fingers – poked at my chest – and, though I had lost over 65 pounds in less than 2 months, said, “If you took better care of yourself, you would not be so sick.”

That’s it. HIS PROGNOSIS was “take better care of health.” GO AND MISBEHAVE NO MORE. There was a doe-eyed med student there whose eyes bugged out of her head, because it was clear that my kidneys were malfunctioning and my central nervous system was too. But because I had a good neurologist giving me support and telling me to KEEP THE FAITH that I WOULD be helped, I realized I needed to show up for myself. And I said, “Woah, so I’m making my kidneys fail and causing myself seizures and losing 65 pounds in 2 months by being simply – UNHEALTHY?” (you may insert the most snotty incredulous tone here you can – because I DID say it with that tone).

And this old bag of rags said, “Well, yes, you are.”

And I got up and walked out while his gums were still flapping. I didn’t bother paying my copay, and I didn’t even look back. Up his nose with a rubber hose. HIS S****Y DOCTORING IS NO REFLECTION OF ME. Really. F*** him. He needs to retire, and he has probably killed so many lupus patients by refusing to properly diagnose us or help us that he’s thinned the US herd single-handedly.

On the way out, I said to the med student, “DO NOT BECOME THIS MAN.” And I left.

I went back to my neurologist who said, “I HATE when I have to do other people’s work.” And he sent me to yet another rheumatologist. It was yet ANOTHER “queen” of lupus in my city. Everyone loves her and you wait an average of 4 hours for your appointment. The receptionist says, “Bring a book – you will wait.” And because I knew what I was in for, I did. And she takes a minimum of 45 minutes to talk to you. She is WONDERFUL. When I told her about the rheumatologists I had seen in the past – at least three of them - she just shook her head. Crappy doctors like that make her work harder, because by the time she sees sick patients like us, we are on full renal failure, our nervous systems are on screaming meemie mode, and we are harder to get healthy again.

So my point is this – I have used the “WALK OUT METHOD” many many times. If a doctor’s mouth is moving and he or she is blaming me or tearing me down without offering me ANY source of hope or positivity ON THE FIRST MEETING, I get up and walk out IN THE MIDDLE OF THE SESSION. Even if you are an alcoholic or severely depressed or have other problems, your doctor should be sensitive to your needs and find a way to WORK WITH YOU on solving these problems, not lecture you and make you feel like a child.

Meanwhile – you do understand that I am a fan of YOU coming through for yourself and YOU being your own hero. So get that I am telling you, the "walk out" method is used for shitty doctors who will kill you if they put their hands on you. But – it saves a “break up” in the long run. You cannot break up with someone you never had a relationship with in the first place!

METHOD 2: THE OPEN CHEAT – “PLAYING THE FIELD”

Once you have been seeing a doctor for some time and things have gone stale, I understand that you might want to leave. It is here where I am more cautious. I am a person who prefers to fan the flame of a relationship rather than leave. I am a person who TRIES to get it going again. I do not easily leave a trusted relationship. I just don’t. If you MUST cheat on your doctor, I say cheat wisely and obviously using full disclosure of all parties.

Tell your new doctor why you are cheating on your old doctor. “I just wasn’t having my needs met. My old doctor isn’t sharing my test results with me and my blood work isn’t being shared. I feel that I’m being treated like one of many – and I only get talk to nurses, though I feel that I am giving my doctor all of my time and attention, being compliant to my medication – my doctor hasn’t reviewed my medication with me in years. If I am taking the time to come in and be a good patient, I want my doctor to do the same. DO YOU THINK YOU HAVE THAT ATTENTION FOR ME, NEW CHEATY DOC? I’d like us to try. I hear you are the latest greatest in the area that I am having trouble, and I NEED to feel good about my care.”

If that is the case, I think a new doctor will be hands offish with you for a bit, but you MIGHT get somewhere. Or you can say you’ve moved and they are closer… or you’ve changed insurance – they might buy it. But to say you aren’t getting along with your old doc and they will automatically suspect YOU of being a difficult patient. I PROMISE.

This goes back to some of the fabulous things Robyn was saying in her comments. You become suspect no matter what. is not fair but it is true. So the best way to cheat is to do it with honesty: “I need to have my needs met and I have heard SUCH GOOD THINGS ABOUT YOU.” Butter them up rather than tear your old doctor down. It is worth a try.

I tried to cheat on my old internist once, but only because she is SO beloved and busy, it was taking me a WEEK to get appointments for emergent things like strep throat – and I have SO MANY doctors and specialists with long waits, I just wanted someone who could see to me IMMEDIATELY (stomp stomp). But it FAILED MISERABLY. I HATED the new internal medicine doctor – who I walked out on after 7 minutes and being told I was both bipolar and I probably have several psychiatric illnesses (I don’t), but I did tell her that her diagnoses meant s*** to me on my way out the door.) I limped back to my internal medicine doctor, apologized for cheating on her and received a BIG FAT HUG for my return. She didn’t even grumble. She HUGGED ME WITH OPEN HAPPY ARMS. I was (and still am) smitten by her treatment of me and her lack of ego and forgiving nature. (Incidentally – I called the chief of staff on the shitty doc b/c she worked in the same place as my internal doc, and because I thought her rude and horrific and terrible. He took my concerns seriously and he told me to stick with my internist because she is a “good egg.” Gotta love those chiefs of staff.)

METHOD 3: IF YOU FEEL IN DANGER – RUN, DON’T WALK

That’s right, cats. If you feel abused or in danger, walk, don’t run, to the exit. After our discussion, Sarah brought up many points about cultural differences and it made me more and more grateful to be in the States right now, where I have both a cultural acceptance towards courtesy and “pleasing the patient.” While this is NOT always the case, I do believe that some cultures are NOT AT ALL like this, and hearing Sarah discuss her experiences abroad has really made me believe that if you are feeling unsafe, you MUST get yourself away from a bad situation.

DANGER, WILL ROBINSON, DANGER! RED ALERT! WARNING SIRENS!

You MUST be educated, aware, and safe.

If you already HAVE a good doctor and lots of trust, you will NOT (or rarely) be in this situation. The best scenario is to have good doctors so that you can get good referrals, should your health take a bad turn. Right now, I trust my specialists so implicitly that I KNOW I can call them for advice, should I need it. If I get a specialist or surgeon who is making me fearful or uncomfortable, I sometimes make an appointment to talk with one of my trusted specialists about it – usually the referring one.

I’ve been known to say, “This surgeon is making me feel like an unruly child.” And my specialist has replied, “Get a different one – go to Rob. I send too many of my patients to the other guy for him to start treating people badly. I like Rob, I was his attending and he’s good. Let me call him.” This has TRULY HAPPENED for me. If your RED ALERT is going off, you should have a specialist you can turn to, who can and will hook a sistah or brosef up when you need surgery or a different specialist.

I will also confess to being so sick that at times, a doctor has said, “I’m putting you on a new medication, would you like to know how it works?” And me, being both highly educated and interested in EVERYTHING about my body, has replied, “No.”(whimper, curl into fetal ball). I could not be arsed. She said, “Well I will give you the nickel tour, so when you DO REALIZE YOU CARE, you will have a decent understanding.”

A good doctor knows when you are SO SICK that you cannot deal with any more information. And she or he will still deal with you. They know what you are like when you are feeling your best, so they know how to handle you when you feel badly.

METHOD 4: KEEPING A GOOD DOCTOR EVEN WHEN THEY F*** UP OR GET GRUFF

We have discussed this in the past, especially Lolly and Sarah.I’m going to reiterate: some of my VERY BEST doctoring and surgical experiences have come from TRUST and relationship building, and NOT FROM RUNNING AWAY.

I cannot put a good point on this except to say it comes from a knowing in your guts. You have to know when a doctor means well and will do well for you. You have to know when something is a mistake and will not be repeated, or when they are sloppy and can harm you.

Most recently, Doc McHotterson and I had it out RIGHT BEFORE MY SECOND SURGERY WITH HIM. It was not pleasant. And yet I realized that he was not being a jerk because he was unhappy, he was sincerely worried on my behalf. And I realized that he is just such a compassionate person, yet the medical industrial complex does not leave space for a good surgeon to say, “Melissa – I don’t want to make your body or your world WORSE. I only want to leave you feeling BETTER.” It made me like him more. I could close my eyes and see his point of view – through his gruffness – and realize his fears were not for himself but for me, though he could not SAY IT.

In many ways, medical school ruins doctors; it creates an inability for honest words and real communication between doctors and patients. Doctors must heal from medical school for years before they “get over” their medical school training. It does not leave space for a surgeon to say what he REALLY WANTS TO SAY. “I’m afraid if you get worse, you will blame me, even though it won’t be my fault. I’m afraid even if I do my best, your body will revolt, and then I’ll feel terrible, and I don’t want to hurt you more.”

In the end, I decided to stay with him. I wrote him a note and told him I believed in him and why. I told him what I wanted and needed from him to make the surgery better for me AND HE DID IT. He totally came through for me. HE REALLY DID. I knew that McHotterson was more than a pretty face. And when all the red lights were going on in my head, I had to get centered and think about fear and the nature of it, and WHY a surgeon would be afraid. Understanding people and their compassion and their genuine goodness of heart helped me trust him and tell him so. It led to a good outcome for me.

If I had run away from this, I think it would have been fine for both of us, but I also think it would have chipped away at both Doc McHotterson and me in the space where people learn to TRUST. How much running away can we do when neither me nor McHotterson is at fault? My sickness is not his fault. His lack of confidence worked in my favor because it opened his heart enough for me to peek inside and see the true meaning behind his fear. Most doctors learn to be more abrasive and blame their patients MORE.

People have the ability to build each other up – in life, in medicine, in all areas. Because I am a chronically ill person, I try to see every opportunity to give and receive love.

I try to do it with humor when possible, and integrity and honesty as well. Doctor McHotterson needed me to show up for him just as much as I needed him to show up for me. I think we both won. I am glad I didn’t run away from his fears or my own. He is a good and honorable man. He will be a great doctor and a surgeon worth waiting for as he progresses. I would be willing to stake my life on that – gruffness or not.

He stood in front of me when as I was preparing to go under and said, “I will take care of you. I will keep you safe.” He changed the course of the surgery for me because instead of being MY OWN HERO, he showed up for me in full shiny armor and made me feel SAFE. I felt surrounded in peace and calm. I felt as though I could stop fighting battles and just let someone support me for a change. I KNEW I adored him for a reason! It gave me space to get on with my own physical healing. It was the most impressive doctoring I have had in many years. Doctoring from the heart is the only way to go – and if I had run away from Doc McHotterson, I would have missed out on his special brand of compassion. And he would have also. I’m not sure he knew he was capable of that. I’m glad we both got to experience it – it has changed us both for the better.